All of the factors considered in assessing mental impairments (e.g., the paragraph A, B, and C criteria in the mental disorders listings) meet the regulations' definition of symptoms, signs, or laboratory findings (12.00B/112.00B of the listing). Consider all these factors in making MIRS comparisons.

Apply DI 28010.015 in the comparison of symptoms, signs, and laboratory findings.

Apply the principles in DI 24583.005 for cases involving the evaluation of mental impairments. For information about which assessments may be used in CDR cases for different scenarios (i.e. no MI, meets a listing, etc.), see DI 28010.050.

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  For specific information about completion of the psychiatric review technique (PRT) or mental residual functional capacity (MRFC) in CDR cases, see DI 28010.140 and DI 28010.145, respectively.

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  For information about completing the assessment documents and documenting determinations on the prescribed form for Title XVI child cases, see DI 25230.001, DI 25230.005, and DI 28005.030C4.

Several mental impairments are considered permanent and severe enough to warrant a MINE diary, such as intellectual disability (listing 12.05A or B or 112.05A) and autistic or other pervasive developmental disorders (listing 12.10 or 112.10); see DI 26525.045. If the individual had a MINE impairment established at the CPD, evidence development at the CDR can often be abbreviated, and the adjudicator may use nonmedical evidence without new medical evidence to find that disability continues if evidence is consistent with such a conclusion; see DI 28030.020A. Functional information may fully support a continuance without the need for extensive development of medical records at the time of the CDR. For additional information about MINE or MINE-equivalent cases, see DI 28040.125.

Before making an unfavorable MIRS decision in a case involving a mental impairment(s), carefully consider the following:

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  Consider the longitudinal history from the evidence, including both medical and non-medical evidence sources. For purposes of evaluating medical improvement, a medically determinable impairment (MDI) does not need to be re-established. Rather, consider sources of medical evidence and functional evidence to evaluate MI; see DI 22511.000.

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  Rating the degree of functional limitations resulting from a mental impairment(s) considering different factors; see DI 24583.005D

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  Consider whether the evidence has been developed sufficiently so that medical improvement and related issues can be evaluated; see DI 28005.009.

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  If the impairment is subject to temporary remission, consider whether any improvement demonstrated may actually only represent temporary remission or improvement of an impairment where symptoms wax and wane, see DI 28010.115.

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  Consider whether the individual's impairment(s) still meets or equals the listing met or equaled at CPD, see DI 28015.050. The flexible approach to the CDR sequential evaluation process may be appropriate to potentially expedite development; see DI 28005.005C

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  Consider whether age and time on the rolls is an applicable factor in Title II and adult Title XVI CDR cases; see DI 28015.310.